The New Zealand medical journal · 2017
Long-term survival following diabetic vitrectomy.
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Kim Bia Z, Lee Kuo-Luong, Guest Stephen J, Worsley David
Аннотация
AIM: To update long-term survival data on patients with proliferative diabetic retinopathy undergoing vitrectomy and to identify associated risk factors.
METHODS: Retrospective clinical record review at a single New Zealand tertiary referral centre. A total of 182 eyes that underwent a vitrectomy for a diabetic vitreous haemorrhage and/or tractional retinal detachment between March 2000 and December 2010 were included. Kaplan-Meier survival curves and Cox-regression analyses were performed for survival rates and associated risk factors.
RESULTS: The mean age of patients was 55 years (range 22 to 85) at time of surgery. The three-year survival rate following diabetic vitrectomy was 83.5%, and the five-year survival rate (N=154) was 70.1%. Increasing age, dialysis and high serum creatinine were associated with poorer survival on multivariate Cox regression analyses (hazard ratio of 1.035, 4.216 and 1.930 respectively with p-values of 0.018, <0.001 and 0.046).
CONCLUSION: Survival rates after diabetic vitrectomy remain relatively poor but comparable to earlier New Zealand and international reports. However, there remain significant differences between ethnic groups within New Zealand that need to be addressed in addition to renal disease, which appears to be a major risk factor for poor survival. Overall, the contemporary survival outcomes observed in this study may influence decision making by patients and clinicians as well as encourage a review of current healthcare resource allocation in diabetes care.
METHODS: Retrospective clinical record review at a single New Zealand tertiary referral centre. A total of 182 eyes that underwent a vitrectomy for a diabetic vitreous haemorrhage and/or tractional retinal detachment between March 2000 and December 2010 were included. Kaplan-Meier survival curves and Cox-regression analyses were performed for survival rates and associated risk factors.
RESULTS: The mean age of patients was 55 years (range 22 to 85) at time of surgery. The three-year survival rate following diabetic vitrectomy was 83.5%, and the five-year survival rate (N=154) was 70.1%. Increasing age, dialysis and high serum creatinine were associated with poorer survival on multivariate Cox regression analyses (hazard ratio of 1.035, 4.216 and 1.930 respectively with p-values of 0.018, <0.001 and 0.046).
CONCLUSION: Survival rates after diabetic vitrectomy remain relatively poor but comparable to earlier New Zealand and international reports. However, there remain significant differences between ethnic groups within New Zealand that need to be addressed in addition to renal disease, which appears to be a major risk factor for poor survival. Overall, the contemporary survival outcomes observed in this study may influence decision making by patients and clinicians as well as encourage a review of current healthcare resource allocation in diabetes care.